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Ditttston  of  ^tmh  affairs 
(Ilnit)et0itp  of  I0ortii  Carolina 


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AIV    ESSAY 


ON   THE 


POSITION  AND  DUTIES 


OF  THE 


MEDICAL   PROFESSION 


IN   THE   MIDDLE   OF 


THE  NINETEENTH  CENTURY. 


BY 

CHARLES  E.  JOHNSON,  M.  D. 

OF  KALEIGH,  N.  C. 


RALEIGH: 

PRINTED   AX    THE    OFFICE    OF    THE    RALEIGH   REGISIEK. 

1858. 


PREFACE 


This  Address  was  prepared  to  be  delivered  in  Edenton  last 
April,  at  the  Annual  Meeting  of  the  State  Medical  Society ; 
but  circumstances  of  a  pressing  nature  prevented  my  atten- 
dance on  that  occasion. 

The  above  statement  will  account  satisfactorily  for  the  matter 
of  the  Address,  and,  to  some  degree  at  least,  for  the  manner  of 
it;  while  the  following  facts  will,  I  trust,  fully  justify  its 
appearing  now  in  pamphlet  form. 

Shortly  after  the  adjournment  of  the  Society  in  April  last, 
at  the  solicitation  of  several  friends  who  were  pleased  to  insist 
that  its  publication  would  "5e  of  decided  benefit  both  to  the 
profession  and  the  publie,''  I  sent  the  Address  to  be  published 
in  the  first  number  of  the  North  Carolina  Medical  Journal, 
which  was  expected  to  make  its  appearance  in  a  few  months. 
For  good  and  sufficient  reasons,  however,  the  first  number  of 
the  Journal  never  was  issued,  and  now  I  am  again  urged  by 
these  friends,  and  by  some  others,  to  bring  this  Essay  before 
the  public. 

Under  these  circumstances,  I  have  concluded  to  publish  it  in 
pamphlet  form,  and  in  its  original  character  of  an  Address 
from  the  retiring  President  of  the  State  Medical  Society. 

CHARLES  E.  JOHNSON. 

Raleigh,  N.  C,  January,  1858. 


ADDRflSS. 


Gentlemen  of  the  Medical  Society  of  the  State : 

It  has  been  the  custom  for  your  retiring  President, 
before  leaving  the  chair,  to  address  you  upon  some  sub- 
ject connected  with  the  interest  and  welfare  of  our 
beloved  profession.  I  do  not  feel  at  liberty  to  depart 
from  so  honorable  a  precedent.  Therefore,  notwith- 
standing my  time  has  been  mainly  engrossed  by  thoughts 
and  efforts  more  eminently  practical  than  theoretical, 
and  notwithstanding,  also,  the  very  eloquent  address, 
somewhat  in  connection  with  the  subject  of  this  dis- 
course, delivered  before  our  Society  twelve  months  ago, 
by  my  talented  young  friend.  Dr.  Edward  Warren,  I  hope 
I  shall  not  be  considered  presumptuous  in  commending  to 
my  professional  brethren,  especially  to  the  younger  ones 
among  us,  the  following  views  for  their  consideration, 
for  I,  too,  was  brought  up  at  the  feet  of  Gamaliel. 

The  middle  of  the  nineteenth  century.  Gentlemen, 
finds  us  hurried  along  with  that  advancement  of  all 
the  arts  and  sciences,  and  material  improvement  of 
mankind,  so  eminently  characteristic  of  the  age  and 
country  in  which  we  live ;  and  the  true  disciple  may 
contemplate,  with  pleasure  amounting  almost  to  delight, 
the  wonderful  progress  and  practical  improvement  that 
the  medical  sciences  have  made  in  the  last  fifty  years  in 
respect  to  the  material  welfare  of  suffering  humanity. 
Nor  need  he  shut  his  eyes  to  the  fact  that  the  moral 
and  ethical  relations  of  the  profession  have  not  been 
neglected  amid  the  general  movement.  Under  existing 
circumstances,  it  is  impossible  for  them  to  have  been 
overlooked.     Constituting  a  most  important  part  of  the 


6 

seiences  of  morals  and  mental  philosophy,  in  all  their 
valuable  relations  with  the  pursuits  and  happiness  of 
human  life,  they  are,  as  objects  of  general  interest, 
receiving  their  full  share  of  the  public  consideration. 
Yet  it  cannot  be  denied  that  the  bare  fact  of  the  sub- 
jects of  metaphysical  theology,  religious  doctrines,  for- 
mulae and  ceremonies,  and  ecclesiastical  government 
and  authority  being  found  mingled  with  this  current  of 
events,  is  considered  by  some  as  an  evidence  of  the  sui- 
cidal progTess  of  civilization.  This  is  worse  than  a 
mistake  sim^ply;  there  is  a  degree  of  Vandalism  in  it; 
for  as  it  is  mischievous  politics,  because  it  is  bad  citi- 
zenship, to  despair  of  the  commonwealth,  so  is  it  both 
more  unphilosophical  and  anti-christian  to  despair  of 
the  ultimate  triumph  of  unfailing  wisdom  and  eternal 
truth.  There  is  no  danger  that  "  the  wisdom  of  cen- 
turies will  be  overturned  "  universally.  It  is  only  the 
dust  and  rubbish  that  will  be  swept  away ;  while  we 
shall  advantageously  become  more  and  more  enlightened 
as  the  mind  advances  to  tlie  attainment  of  higher  and 
more  comprehensive  views  of  Nature  and  of  Nature's 
God.  Inaccurate  and  imperfect  knowledge,  handed 
down  from  one  generation  to  another,  constituting  tra- 
ditional information,  may  be  quite  as  pernicious  in 
morals  and  religion  as  it  is  known  to  be  injurious  in 
physical  philosophy;  because,  as  in  the  latter  case,  it 
certainly  perpetuates  error  with  the  obstinacy  engen- 
dered by  the  evidence  of  ill-observed  facts  and  popular 
prejudice,  so  in  the  former,  being  subjective  to  the  pre- 
established  opinions  of  others,  it  is  eminently  capable 
of  hindering  the  mind  in  its  efforts  to  comprehend  and 
appreciate  those  great  psycological  principles  and  truths, 
which  conclusively  show  that  the  theology  of  the  Bible, 


being  the  word  of  God,  and  the  theology  of  Nature, 
bemg  the  work  of  God,  must  be  ulthnately  one.  It  is 
as  vain  and  foolish,  if  not  wicked,  therefore,  to  imagine 
that  the  more  we  learn  to  comprehend  and  thoroughly 
understand  the  teachings  of  the  Bible,  the  less  we  shall 
venerate,  love  and  adore  God,  as  it  is  ridiculously 
absurd  to  suppose  that  nature  will  by  degrees  lose  a 
portion  of  the  charm  and  magic  of  her  power,  as  we 
learn  more  and  more  how  to  unveil  her  secrets,  and  to 
comprehend  her  laws.  Each,  in  itself,  but  harmoni- 
ously with  the  other,  is  in  fact,  a  perfect  revelation  of 
Almighty  power,  and  wisdom,  and  goodness,  and  mercy ; 
and  it  is  man's  bounden  duty,  therefore,  by  dihgence 
and  research,  to  learn,  as  far  as  he  i^  capable  of  doing 
so,  to  comprehend  and  appreciate  both  of  them,  since 
God  never  designed  to  conceal  Himself,  either  by  word 
or  deed,  from  any  one  of  Eis  creatures,  nor  to  constitute 
only  a  few  of  them  the  sole  recipients  of  that  knowledge 
of  his  power,  and  wisdom,  and  goodness^  and  mercy, 
which  was  intended  equally  for  all. 

Then  I  shall  not  occupy  your  tune  in  discussing  this 
question  with  such  '^hopeless  and  helpless"  speculators 
in  the  realms  of  thought  and  feeling  and  duty.  They  do 
not  see  that  such  inquiries  are  the  natural  consequences 
of  that  mighty  upheaval  in  the  moral  and  intellectual 
world,  which  is  going  on  around  them,  and  that  it  is  on 
that  account  they  are  occu]3ying  the  thoughts  and  pens 
of  a  large  and  influential  portion  of  every  enlightened 
community.  Nor  have  they  learned  that  indiscrimi- 
nate reliance  on  authority  no  longer  exists ;  and  that 
all  blind  followers  of  the  blind  must  suffer  the  conse- 
quences of  sapless  stupidity,  or  self-confident  bigotry. 
The  present  age  being  eminently  distinguished  by  its 


8 

progressive  tendency,  there  is  not  only  a  rapidly  decreas- 
ing disposition  to  reliance  upon  jprescriiAioyi  and  au- 
thority, but  so  far  as  it  remains,  a,ccording  to  my  obser- 
vation, it  depends  more  on  personal  regard  and  confi- 
dence in  the  individual,  than  upon  any  general  or 
special  acknovvdedgement  of  prescriptive  right.  Every 
thing  now  is  presumed  to  be  capable  of  improvement ; 
and,  in  consequence,  every  thing  is  subjected  to  the 
most  careful  and  searching  scrutiny ;  its  foundations 
are  examined,  its  truths  tested  ;  and  wherever  a  dispo- 
sition to  oppos3  free  inquiry,  no  matter  by  what  name 
it  may  be  called,  or  an  inclination  even  to  cling  too 
closely  to  the  past,  is  discovered  to  exist  in  regard  to 
any  subject,  or  fancied  to  exist,  on  the  part  of  those 
connected  with  it,  there  will  inevitably  follow,  general 
distrust  and  want  of  confidence.  To  assume  the  con- 
trary, and  attempt  to  maintain  confidence  by  authority 
only,  would  expose  any  man  in  this  age,  no  matter 
what  his  position  or  calling,  to  both  censure  and  ridi- 
cule; and  rightly  too,  for  both  experience  and  right 
reason  have  abundantly  proven  that  oppression,  either 
physical  or  moral,  is  not  the  fixed  fate  of  man.  It  is 
true  that  superior  physical  power  may,  for  a  time,  give 
some  the  ascendancy,  and  superior  intelligence  may 
attain  its  destined  eminence,  although  its  possessors,  for 
a  time,  exercise  their  power  unjustly,  oppressively, 
creating  a  state  of  things  in  which,  by  the  aid  of  brute 
force,  in  the  one  instance,  those  of  inferior  condition  have 
risen  at  the  expense  of  those  of  superior  intelligence, 
while  in  the  other,  superior  intelligence,  diverted  from 
its  legitimate  purposes  of  wisdom  ani  usefulness,  has 
degraded  and  afflicted  those  who  rank  below  it,  in  an 
inferior  condition.     Bat  neither  of  these  conditions  of 


9 

oppression  constitutes  the  fixed  and  determined  state  of 
man  In  this  world ;  because  eo.ch  violates  the  eternal 
]jimCiples  of  dath  nnd  jujtice,  in  being  antaf^oniscic  to 
the  /floral  i7hj_^roveme:it  and  material  irelfare  of  ilie  ma" 
jori'y.     And  so,  OL.r  present  high  a  ^   advanced  state 
of  civiiisadon  cler^'^y  d^n-onstrates  ttc  there  are  demo- 
cratic Timciples  a\  the  arts  and  sciences,  underlying 
the   republic   of  letters,  just  as  thre  a^e  aerno^ratic 
principles  in  politics,  undeilv  Lig  the  conmionwerlui  of 
governments ;  and  that,  as  in  the  case  of  the  latter, 
there     '^  nc  ^nst  powers  save  those  derived  from  the 
coi:sent  of  the  governed,  so  in  the  case  of  the  former, 
there  is  x  :>  proper  authority  or  prescriptive  right  above 
and  independent  of  those   who  support  it.     In  other 
words,  just  as  the  safety  and  welfare  of  the  citizen 
should  be,  as   regards  all   gcveminents,  a  paramount 
consideration  with  the  state,  so  should  the  safety  and 
best  interests  of  the  patient,  as  regards  the  practice  of 
medicine,  be  the  chief  concern  of  the  medical  profession. 
Now,  I  have  a  ''  relfs^  sense  "  that  too  much  reUance 
upon  the  Doctorate,  without  duly  qualifying  ourselves 
for  the  onerous  labors    and  responsible  duties  of  the 
medical  scholar  and  practitioner,  has  scarcely  left  to  the 
individual  members  of  our  profession,  merely  as  such,  the 
prestige  even  of  that  oracular  air  and  magisterial  au- 
thority, which  gave  them  once  a  sort  of  dictatorial  power 
over   the   minds   of  men   in   their   peculiar  vocation, 
resembling  that  possessed  by  the  priest  at  the  confes- 
sional.    But  we  cannot  complain  of  society  for  this ; 
Ave  must  blame  ourselves ;  for  I  shall  pr^^ocntly  show 
that  the  prc^^sing  wants  and  necessities  of  every  enlight- 
ened state  and  community  actually  require  of  the  medi- 
cal man  to  take  a  more  responsible  and  useful  position 


10 

in  society  than   formerly,  just  in  proportion  as  civi- 
lization spreads,  and  the  masses  become  enHghtened. 
But  if  Ave  have  neglected  to  improve  the  advantages 
which  civilization  offers,  by  failing  to  possess  ourselves 
of  that  full  amount  of  useful  kno^yledge  which  the 
present  advanced  state  of  the  medical  sciences  furnishes 
to  every  earnest  student  and  diligent  cultivator  of  the 
profession  of  medicine,  whose  fault  is  it  ?     Under  such 
circumstances,  can  we  reasonably  expect  of  society  to 
.  tolerate  our  short-comings  ?  or  shall  we  importunately 
seek  of  the  body  politic  those  ad\'^ntitious  aids  and 
helps  which  we  should  not  need  if  all  of  us  did  our  duty? 
Indeed,  must  we  think  it  strange,  while  this  is  found  to 
be  the  case  among  those  who  were  once  looked  up  to, 
on  account  of  their  profession  only,   as  oracular  and 
infallible,  if  distrust    should   creep  in,  and  even  the 
actual  amount  of  our  certain  knowledge  should  come  to 
be  undervalued  ?     "  There  is  no  self-sustaining  power," 
says  an  eminent  writer,  "in  any  form  of  social  organi- 
zation.    The  only  self-sustaining  power  is  in  individual 
virtue."     Then,  as  the  old  claims  of  authority,  to  which 
we  ourselves  ha,ve  clung  much  too  long,  longer  in  fact 
than  many  of  us  are  fully  aware  of,  are  rapidly,  and, 
as  I  believe,  justly  losing  their  influence,  and  passing 
away,  we  must  attain  to  greater  individual  excellence, 
by  increased  acquirements,  and  by  a  more  comprehen- 
sive and  unselfish  discharge  of  duty  in  the  responsible 
position  which  the  age  assigns  our  profession,  if  we 
desire  to  establish  a  solid  appreciation  of  our  worth  in 
the  minds  of  those  whose  good  opinion  it  is  our  interest, 
as  it  should  be  our  happiness  to  obtain ;  or,  if  we  hope 
to  escape  becoming  the  victims  of  civilization. 


11 

That  most  remarkable  man,  the  Emperor  of  the 
French,  in  his  late  speech  opening  the  legislative  assem- 
bly of  France,  said  :  "  Civilization,  though  its  object  is 
the  moral  improvement  and  material  welfare  of  the 
majority,  advances,  it  must  be  admitted,  like  an  army ; 
its  victories  are  not  gained  without  sacrifices  or  A\4thout 
victims."  This  is  most  true ;  but  while  I  am  ready  to 
admit  that  individuals,  commerce,  and  even  states  are 
sometimes  throAvn  out  of  gear  by  the  rapidity  of  this 
universal  movement,  I  am  also  prepared  to  show  that, 
under  a  wise  employment  of  natural  circumstances 
and  the  advantages  which  progress  and  improvement 
offer  us,  prosperity  is  not  suicidal,  but  capable  in  an 
eminent  degree  of  promoting  ^'the  moral  improvement 
and  material  welfare  of  the  majority."  But,  you  will 
ask,  how  shall  this  be  accomplished  in  regard  to  the 
profession  of  medicine  ?  Listen ;  and  I  mil  present  you 
some  hasty  sketches  of  real  life,  or  panoramic  views,  as 
it  were,  of  the  moving  multitudes  that  compose  this 
advancing  army  of  civilization,  and  therefrom  endeavor 
to  draw  lessons  of  "s^dsdom,  that  shall  in  their  application, 
be  a  full  answer  to  your  inquiry. 

The  electric  wires,  railways  and  steam  navigation, 
those  rapid  means  of  communication  between  the  ends 
of  the  earth ;  machiner}',  new  currents  of  trade,  the 
influx  of  gold,  the  indefinite  expansion  of  credit,  and 
other  elements  of  unprecedented  prosj^erity — in  our  own 
country  especially,  the  incalculable  benefits  of  civil  and 
religious  freedom,  a  free  press  and  free  schools — leave 
many  unfortunates  far  behind,  and  aground,  high  and 
dry,  demanding  in  vain  that  circumstances  shall  be 
adjusted  to  suit  their  characters  of  indecision  and  want 
of  capacity. ,   Leave  them  alone.     They  are  veritable 


12 

old  fogies  whom  the  current  of  events  has  thoroughly 
enasculated,  so  far  as  the  practical  pursuits  and  useful 
purposes  of  life  are  concerned. 

Again ;  there  are  some  who  join  in  the  forward  move- 
ment of  the  armj^  of  civilization,  with  objects  of  pleas- 
ure only,  and  who,  by  adventitious  aids,  keep  time  with 
lU  progress  for  a  while ;  but,  having  led  wastefully  ex» 
travagant,  idle  and  luxurious  lives,  without  one  single 
Self-sustaining  mortal  or  intellectual  principle  for  the 
propet*  l^egulation  of  human  conduct,  their  existence  is 
an  unnatural  and  feverish  one,  and  they  soon  become 
laggards,  from  exhaustion  of  mind  and  body,  and  in 
their  weakness  are  run  over  by  the  moving  masses 
and  trampled  under  foot  as  the  very  dung  of  the  earth* 
Let  them  go  too.  They  deserve  their  fate ;  for  in  their 
lives  they  iiave  only  served  to  point  a  moral  or  adorn  a 
tale,  by  throwing  away  blessings  and  opportunities  which 
humbler  and  wiser  men  would  have  rejoiced  in,  as 
affording  them  the  means  of  extended  usefulness  and 
beneficence. 

And  again ;  there  is  another  class,  the  members  of 
which  make  haste  to  get  rich,  or  to  obtain  place  at  any 
Bacrifice  of  justice,  truth,  right,  reason  and  humanity, 
fojr  the  purpose  of  having  wealth  or  power  that  shall 
minister  to  their  pride  of  heart  and  mere  sensual  grati- 
fications, forgetting  that  man  is  not  placed  in  the  world 
of  sense  alone,  but  that  the  essential  root  of  his  being 
is  in  God,  and  that  whatever  man  does,  so  long  as  he 
does  it  for  himself  only,  as  a  finite  being,  and  through 
his  own  counsel  for  his  own  purposes,  it  is  vain,  and 
wicked,  and  foolish,  and  will  sink  to  nothing.  Yielding 
to  one  of  the  grossest,  most  debasing  priticiples  of 
human  nature,  and  one  which  will  be  sure  to  reveal 


13 

itself  in  their  outward  lives^  tliey  incur  tli^  Inifailing 
tualediction  of  the  Wise  man,  ''  that  he  Who  mahetli 
ha-^ie  to  he  rich  shall  not  he  innocent,''  and  that  "  lie  that 
trusteth  in  his  own  heart  is  a  fool!'  These  persons  whom 
fVuition  disappoints,  complain  even  of  success,  and  gen- 
eMly  act  out  their  part  in  life,  by  becoming  giddy^ 
intoxicated,  from  the  insane  pursuit  of,  and  thoughtless^ 
wicked  devotion  to,  the  god  of  their  idolatry,  and  are 
piresently  thro^vn  reeling,  tottering,  tumbling  headlong 
irom  their  course,  to  rise  n'^  more,  but  to  "  die  as  the 
fool  dieth."  Let  the  dead  bury  their  dead;  we  take  care 
of  the  livino:. 

But,  on  the  other  hand,  there  afe  those  who  are 
convinced  that  human  nature  was  certainly  made  for 
greater  things  than  the  mere  enjo}nilent  of  sense,  since 
it  is  capable  of  nobler  advancements  by  the  constant 
exercise  of  wdsdom  and  virtue;  and  Vvdio  believe  that 
man  shall  he  and  do  something  in  his  temporal  life, 
the  remembrance  and  reality  of  which  shcJl  not  only 
be  left  behind  him  as  a  monument  of  his  usefulness, 
and  as  a  beacon  light  to  guide  those  who  follow  after 
him,  but  the  genuine  spirituality  and  Unselfish  grandeur* 
of  which  shall  fit  his  outward  finite  life,  with  gladden-- 
ing  consciousness,  to  taste  of  the  unspeakable  joys  and 
glories  of  the  infinite.  They  believe  that  the  Image  of* 
God,  the  Diviiie  Idea,  which  constitutes  the  chiefest 
element  that  lies  in  the  essential  nature  of  man,  ren-* 
dering  it  capable  of  use  filllless,  grandeur  and  happiness^ 
must  become  with  them  a  fxed  idea,  an  unchangeable 
principle,  pervading  and  determining  all  their  inward 
thoughts  and  outward  actions ;  that  throughout  their* 
lives  they  must  be  accolnpanied  by  the  indestructible 
consciousness  that  God's  purposes  are  accomplished,  and 


14 

his  work  acliievecl  through  the  instrumentahty  of  men  ; 
and  therefore,  that  they  shouht  always  look,  in  every 
pursuit  and  occupation  of  life,  whether  of  the  high- 
est or  lowest,  to  an  enlightened  and  properly  cultiva- 
ted understanding  and  a  genuine  christian  consciousness 
for  proper  counsel,  and  implicitly  follow  its  guidance  as 
the  only  true  wisdom  that  can  ensure  them  prosperity, 
power  and  peace.  It  is  generally  true,  perhaps,  and 
should  be  universally  so,  man  being  a  rational  creature, 
endowed  with  an  imperishable  soul,  that  human  char- 
acter and  conduct  are  formed  and  governed  by  fixed 
rules  and  precepts ;  and  so,  it  must  be  admitted,  that 
just  in  the  proportion  that  men  are  possessed  with  the 
conviction  that  in  them  and  by  them,  God's  work  on 
earth  shall  be  achieved,  and  his  will  accomplished,  just 
to  that  same  degree  will  they  become  immovably  con- 
vinced that  the  whole  material  world,  with  all  its  adap- 
tations, and  ends,  and  in  particular  the  life  of  man  in 
this  world,  are  only  so  many  means  in  themselves  to  be 
used  by  them  for  God's  wise  and  merciful  purposes  in 
promoting  "the  moral  improvement  and  the  material 
welfare  of  the  majority."  And,  as  the  consciousness  of 
responsibilit}^  is  more  eminently  a  moral  than  an  intel- 
lectual element  of  the  human  mind,  it  follows  as  a  known 
result,  that  in  proportion  as  responsibilities  are  felt, 
position  will  be  appreciated ;  and,  therefore,  that  every 
true  man  will  rise  equal  to  emergencies,  just  iii4te 
proportion  as  he  realizes  the  sense  of  responsibility  and 
the  sense  of  position.  Then,  no  matter  what  their 
occupation  in  life,  whether  engaged  in  the  cabinet  or 
the  field,  in  the  laboratory  or  the  workshop,  whether  hus- 
bandmen, artizans,  or  professional  men,  being  possessed 
of  all  the  necessary  elements  of  successful  enterprise, 


15 

important  usefulness  and  distinguished  merit,  they 
will  be  instant  in  and  out  of  season,  laboring  faithfully 
under  the  impulses  of  an  enlightened  self-interest,  regu- 
lated by  a  well  directed  regard  for  the  interest  and 
welfare  of  others,  and  a  conscientious  observance  of  the 
revealed  truths  of  eternal  »\yisdom  and  justice.  Then 
will  the  essential  element  of  the  nature  of  men,  the 
Image  of  God,  necessarily  reveal  itself  in  their  outward 
lives,  shine  forth  in  all  their  thoughts,  desires,  and  acts, 
and  become  their  unvarying  and  unalteraljle  character, 
which  will  be  much  .more  respected  and  venerated  than 

'=Tlie  shadows 
Tliat  Icccp  the  keys  of  all  the  creeds." 

Yes,  these  are  the  true  representative  men  of  the  age, 
whose  maxim  is,  '"  Nmiquam  non  parafus^  lahoraregue 
est  orare,  ac  forti  et  fideli  nil  difficile^'  and  who,  when 
they  are  understood,  will  receive  the  full  and  perma- 
nent conMence  of  mankind,  because  they  are  capable 
of  conferring  the  most  desirable  benefits  upon  them,  as 
well  in  mitigating  human  suffering,  as  by  multiplying 
their  rational  enjoyments. 

Now,  gentlemen,  look  at  these  pictures,  which  are 
nothing  more  or  less  than  sketches  of  leal  life,  presenting 
the  only  rational  view  of  the  movements  of  civilization, 
and  tell  me  vdiich  is  Satyr,  which  Hyperion ;  and  then 
tell  me  also,  with  which  class  the  members  of  the  medical 
profession  should  always  be  found ;  luider  which  stand- 
ard, with  reasonable  hopes,  they  may  expect  to  be 
always  able  to  march  fcjrward  in  the  discharge  of  the 
onerous  and  responsible,  but  invaluable  duties  of  their 
high  and  benevolent  calling.  In  the  anticipation  of  a 
glorious  future,  can  you  hesitate  under  which  banner 
you  will  enlist  ?     If  you  doubt,  an  attentive  considcra- 


16 

tion  of  what  society  requires  of  every  medical  man  who 
claims  its  confidence  and  support,  will  readily  r  oint 
out  to  you,  not  only  that  your  proper  place  is  m  tho 
foremost  ranks,  but  it  vfill  likewise  teach  you  that  you 
must  there  struggle  manfully,  shoulder  to  shoulder, 
with  the  philanthropists  and  philosophers  of  the  age ; 
for,  among  highly  civilized  nations,  the  medical  man 
has  become  a  necessary  part  of  the  social,  moral  and 
political  condition  of  the  people.  This  makes  the 
science  of  medicine  emphatically  the  science  of  human 
nature,  and  imposes  upon  the  profession  proper,  a  role 
of  duties  commensurate  with  the  most  comprehensive 
schemes  for  the  promotion  of  the  best  interest  and 
welfare  of  humanity.  Consequently,  medical  men  are 
expected  to  strengthen  their  minds  by  diligent,  earnest 
cultivation ;  to  develope  them  in  the  widest  range  of 
practical  and  scientific  attainments ;  and  more  than  all, 
to  consecrate  them  in  their  strength  and  fullness  to  the 
loftiest  aims  and  the  most  beneficent  purposes  of  use- 
fulness. "  2 hen  give  jpiJace  to  the  'physician^''  for  it  may 
be  asserted,  without  the  fear  of  contradiction,  that  the 
medical  man  being  the  recognized  cultivator  and  applier 
of  the  sciences  of  human  nature,  has  a  mighty  future 
mission  to  fulfil  towards  sufiering  humanity.  But  to 
enable  him  to  fulfil  this  mission,  he  must  not  only  be 
prepared  with  learning  and  wisdom  to  discharge  the 
arduous  labors  of  his  calling,  but  he  must  be  v,^ell-bred, 
kind,  considerate,  attentive,  enduring,  patient,  forgiv- 
ing, firm ;  in  a  word,  he  must  think  like  a  philosopher, 
feel  like  a  woman,  and  act  like  a  hero.  Then  he  will 
be  admitted  to  the  fullest  confidence,  and  be  made  the 
depository  of  secrets  that  bind  together  the  whole  fabric 
of  society  \  aye,  the  wise  counselor,  in  its  pux^poses  of 


17 

usefulness  and  beneficence,  of  the  stat(.^  itself.  Indeed, 
is  that  not  the  case  now  with  the  deserving  pliysician  ? 
And  does  he  not  now  occupy  a  position  of  singular  inliu- 
ence  and  great  moral  power,  such  as  the  priest  once 
held,  with  this  advantage,  that  he  is  placed  in  that 
situation  by  society  itself  as  a  legitimate  result  of  civili- 
zation, because,  from  the  nature  of  his  studies  and  the 
research  of  his  art,  he  reads  more  deeply  into  the  human 
heart,  and  wisely  penetrates  into  its  inmost  recesses  ; 
whereas,  the  priest,  assuming  to  rule  by  Divine  Rlght^ 
demands  implicit  obedience  and  an  entire'  surrender  of 
our  reasoning  powers  to  what  he  asserts  to  be  the 
mandate  of  Heaven,  which  he  is  especially  delegated 
to  proclaim. 

Yfhile  ministering  to  the  body  the  physician  is 
exploring  the  mind;  for  io  him  alone  do  men  speak 
without  the  least  reserve,  candidly,  and  jx^rhaps  with 
even  more  than  candour.  Moreover,  the  phenomena 
presented  by  the  human  body,  in  health  and  disease,  are 
most  complicated  in  their  character,  being  the  o  mbined 
result  of  every  physical  law,  perhaps,  which  is  found 
operating  elsewhere  in  nature,  and  of  two  other  pecu- 
liar elements  of  power,  nerve  force  and  mind,  that  are 
^'  mightier  than  all,  overtopping,  complicating  all ; 
working  now  in  harmony,  now  in  discord,  but  always 
w^orking  with  them  all,"  to  elaborate  the  phenomena  of 
humanity,  which  the  medical  man  must  study,  as  well 
in  health,  when  all  nature  seems  to  smile  upon  us,  as  in 
disease,  when  known  influences  are  at  work  against  us,  or 
when  unknown  ones,  that  "  walk  in  darkness  and  waste 
at  noonday,"  seem  plotting  our  destruction.  And,  if  the 
grosser  agency  of  the  body,  reacting  constantly  on  the 
complex  and  delicate  operations  of  the  mind,  chances  to 
3 


18 

destroy  its  otherwise  beautiful  proportions  and  consen- 
taneous actions ;  or  if,  on  the  other  hand,  the  mind  being 
disturbed  in  its  healthy  disposition  and  exercise,  or  de- 
formed, perhaps,  in  its  original  constitution,  should  be- 
come the  disturber  of  the  lawful  and  harmonious  actions 
of  our  physical  natures ;  who  will  be  expected  above  all 
others  to  make  both  mind  and  body  equally  the  subjects 
of  his  most  anxious  study  and  careful  exposition,  but  the 
conscientious  and  enlightened  physician  ?  Tiie  duty  is 
a  high  and  responsible  one,  and  he  who  hopes  to  dis- 
charge it  wisely,  faithfully,  must  have  a  w^orld-wide 
philosophy,  embracing  within  its  comprehensive  folds 
all  races,  ranks,  conditions  and  intellects ;  in  a  word,  the 
wdiole  phenomena  of  humanity.  He  must  not  only  be 
able  to  expound  and  apply  the  laws  of  physics  and 
physiology,  pathology  and  therapeutics,  but  he  must 
become  a  psychologist,  a  seeker  and  teacher  of  those 
great  ethical  truths  and  moral  duties,  which  are  fool- 
ishly thought  by  some  to  belong  to  the  students  of 
metaphysics  and  theology  only,  notwithstanding  rea- 
son and  the  noral  sense  both  proclaim  that  the  sepa- 
ration of  psychology  and  physiology  is  an  unnatural 
divorce  of  those  things  which  God  has  wisely  and 
mercifully  joined  together.  Hence  it  is  the  medical 
man's  province  to  assuage  human  suffering  in  all 
its  varieties  and  aggravations,  whether  of  physical  or 
moral  disease,  whether. as  confined  to  individuals,  com- 
munities, or  as  belonging  to  the  state.  He  wages  per- 
petual warfare  with  deadly  disease,  and  fearlessly  exerts 
himself  to  the  utmost  of  body  and  mind,  to  stay  the 
ravages  of  plague  and  pestilence ;  and  it  is  in  his  energy 
and  j  udgment,  but  above  all  in  his  honesty  of  purpose, 
that  the  people  have  to   confide  for  immunity  from 


19 

those  fearful  epidemical  visitations  which  periodically 
thin  their  ranks.  He  is  ever  called  upon,  throughout 
his  whole  professional  life,  to  fight  that  never  ending 
battle  of  poverty  against  the  proud  man's  contumely 
and  the  greedy  man's  avarice;  while  sometimes,  he  has 
to  throw  the  whole  weight  of  his  intellectual  and  moral 
force  between  the  strong  arm  of  the  law,  and  some 
unfortunate  member  of  society,  against  whom  it  is 
uplifted,  in  the  sacred  name  of  justice,  and  with  all  its 
dread  formalities,  to  inflict,  not  punishment,  but  ven- 
geance. How  often,  too,  is  the  medical  man  called 
upon  to  mourn  over  that  antagonism  between  the 
ermine  on  the  bench,  and  the  rags  at  the  bar,  which  he 
sees  and  feels  to  be  too  unnatural  to  be  right,  because 
the  true  moral  dignity  of  human  nature  is  outraged  not 
miuch  more  in  the  culprit  than  in  the  judge. 

With  the  good  physician,  then,  it  is  a  subject  of  hon- 
orable boast,  that  science  and  learning  are  merely  the 
necessary  means  to  an  important  end ;  that  all  his  knowl- 
edge is  eminently  practical,  and  its  greatest  purpose  be- 
nevolence. Therefore,  it  is  devoutly  to  be  hoped,  that 
the  punishment  and  reforma,tion  of  criminals,  as  is  now 
almost  universally  the  case  in  regard  to  the  insane,  will 
ultimately  come  within  the  pale  and  under  the  dominion 
of  medical  science.  A  sound  philosophy  and  a  genuine 
christian  consciousness  ought,  and  must,  plead  against 
all  blind  vengeance,  and  unmeaning,  useless  cruelty ; 
and  I  believe  they  must  and  will  appeal  at  last,  to  medi- 
cal science  for  the  means  and  mode  whereby  mercy  and 
justice  may  be  linked  together.  Who,  so  well  as  we, 
are  entitled  to  open  the  door  to  moral  and  intellectual 
sources  of  improvement  ?  We  have  unequalled  oppor- 
tunities for  observation  and  reflection  ;  are  called  upon 


20     ' 

daily  to  watcli  the  secret  workings  of  liimian  passions 
and  to  trace  the  progress  of  mankind  in  virtue  and  hi 
vice ;  and,  as  a  consequence,  I  will  boldly  ask,  where 
will  you  find  so  little  bigotry,  so  little  prejudice  ?  We 
consider  the  subjects  of  health  and  recovery  frolii  dis- 
ease, whether  physical  or  moral,  as  objects  of  paramtjunt 
importance ;  and  should  seek  to  establish  and  apply  tliB 
principles  and  practice  of  our  profession  without  regard 
to  other  considerations  than  the  discovery  and  declaration 
of  the  truth,  and  the  safety  and  welfare  of  all. 

In  devising,  and  in  superintending  all  sanitary  refor- 
mations and  plans  of  medical  police,  we  are  expected  to 
co-operate  understandingly,  and  as  advisers,  with  the  leg- 
islature and  with  the  civil  authorities,  with  parents  and 
guardians,  and  with  the  architect  and  engineer.  Then 
we  must  call  to  our  aid  all  the  knowledge  which  the 
state  of  civilization  in  the  arts  mid  sciences  furnishes, 
and  endeavor  to  give  it  proper  direction  and  availability 
for  "the  moral  improvement  and  material  welfare  of 
the  majority, '  by  means  of  the  statutory  acts  of  enlight- 
ened governments,  the  efficient  administration  of  the 
civil  authority,  and  the  systematized  efforts  of  practical 
philanthropists  ;  while  we  should  always  be  ready  in 
person  to  superintend  the  execution  of  what  we  may 
theoretically  recommend.  In  fact,  practitioners  of  medi- 
cine will  always  be  compelled  from  their  honorable  and 
responsible  position  in  society,  even  if  they  should  not 
feel  bound  by  the  sacred  principles  of  natural  and 
revealed  religion,  to  exeri  themselves  for  the  improve^ 
ment  of  the  physical  and  moral  conditions  of  mankind. 
All  those  legislative  measures  and  pUilantliropic  efforts, 
therefo' ^,  which  have  this  object  in  view,  will  not  only 
receive  tlieir  cordial  support,  but  will  likewise  be  found^ 


21 

Vtpon  inquiry,  in  most  instances,  actually  to  kdve 
received  their  original  impulse  or  riglit  direction  from 
medical  men.  And  particularly,  in  those  more  directly 
practical  labors  which  contribute  to  the  alleviation  of 
human  suffering,  where  will  you  find  more  earnest  or 
more  faithful  ministers  of  Providence,  than  those  whom 
no  toil  or  danger  restrains  from  attending  to  the  simple 
call  of  professional  duty,  alike  in  the  hovel  as  in  the 
palace,  in  the  squalid  haljitations  of  penury  as  in  the 
abodes  where  wealth  contribu^:es  its  utmost  to  mitigate 
the  discomforts  of  the  suiferer-;  for  thev  know  that 
oftentimes 

'•  PiiUida  ^Hiors  aeqtih  ^uhrfi  pede 
P(iupei'it)>i  tabenias  regwnque  furres." 

"He  (the  practitioner)  is  a  social  reformer  in  the 
highest  sense  of  the  word,"  says  an  accomplished  writer. 
"Everywhere  he  comes  in  contact  with  misery  and 
vice,  with  degraded  habits  and  injurious  customs,  with 
the  numerous  families  of  the  poor,  and  the  sterile  panv 
pered  homes  of  the  rich.  To  tdl,  he  can  give  advice 
with  benefit,  and  in  every  sphere  of  labor  diffuse  a, 
kno^'ledge  of  hygiene."  Medical  men  have  been  mainly 
instrumental  in  providing  due  space  for  ventilation,  and 
in  other  respects  securing  the  highest  salubrity  attaina^ 
ble  by  architectural  arrangements  and  thorough  drain- 
ing ;  and  to  them,  also,  may  all  our  additional  comforts 
and  meliorations,  in  cleanliness  and  warmth,  clothing 
and  food,  physical  aaid  moral  training,  be  chiefly  attrib^ 
*  uted.  Those  wretched  states,  sickness  and  poverty  and 
criivr,  which  are  so  often  linked  together  by  the  tongues 
of  men,  but  of  which  they  actually  i:now  so  little,  we 
see  m  our  daily  rounds,  walk  really  hand  in  hand*. 
We  Jcnmv  that  where  there  is  much  poverty  and  sickness 


22 

there  is  much  ctime,  and  that  whei'e  there  is  much 
crime  and  poverty  there  will  be  much  sickness ;  and 
with  all,  from  public  neglect  and  "man's  inhumanity 
to  man/'  a  helplessness  of  degradation,  a  clouding  of 
the  faculties,  a  dullness  of  the  moral  sense,  a  prostra- 
tion, in  a  word,  of  the  God-liive  powers  of  humanity, 
that  leave  little  to  hope  for  the  position  of  beings  in  the 
next  world,  so  degraded,  so  debased  in  this. 

Now,  relief  of  poverty  from  the  public  purse,  as  a 
social  right,  is  one  of  the  characteristics  of  modern  civi- 
lization ;  and  this  principle  should  be  further  extended 
so  as  to  include  relief  of  sickness.  Then  we  should  not 
only  have  a  lessened  amount  of  poverty  and  sickness  and 
crime,  but  a  class  of  intelligent  and  useful  citizens,  the 
practitioners  of  medicine,  would  be  relieved  from  a 
burdensome  tax,  for  the  imposition  of  which  no  good 
reason  can  be  given,  and  for  which,  they  receive  no 
return  whatever  from  the  body  politic,  either  in  the 
way  of  actual  remuneration  or  fostering  care. 

On  the  subject  of  education,  believing  that,  as  man 
is  nearer  to  the  diety  in  wisdom  and  knowledge,  as  well 
as  in  grace  and  goodness,  in  that  same  proportion  will 
he  be  nearer  to  the  deity  in  the  future  state,  the  happi- 
ness of  which  depends  upon  the  soul's  knowledge  as 
well  as  its  love  of  God,  the  diffusion  of  useful  knowledge 
among  tlie  masses  will  be  to  him  a  question  of  trans- 
cendent importance,  and,  therefore,  he  will  insist  that  it 
be  conducted  on  the  soundest  scientific  and  christian 
principles.  In  his  estimation,  it  is  not  "  sufficient  that 
the  mere  organs  of  mental  action  be  developed,  but  it 
is  also  required,  that  they  be  developed  with  a  reference 
to  the  motives  from  wliich  they  will  act,  and  to  the 
final  cause  of  their  action ;  otlierwise,  the  training,  so 


2 


o 


far  from  being  a  good  to  man,  may  be  an  evil,  by  afford- 
ing him  greater  power  for  the  commission  of  evil  and 
of  departure  from  God."  Now,  the  intelligent  practi- 
tioner knows  that  "  this  better  state  of  knowledge  "  can 
only  be  attained  by  a  proper  training  and  development 
of  all  the  faculties,  physical,  moral  and  intellectual,  and 
that  these  are  best  to  be  attained  by  a  thorough  knowl- 
edge of  physiological  laws.  Hence  there  is  an  obvi- 
ous propriety  in  the  medical  man's  being  connected  with 
all  comprehensive  schemes  or  educational  plans  for  the 
useful  development  of  man's  faculties. 

But  our  duties  are  not  confined  to  home  or  a  circle  of 
selected  friends  and  acquaintainces.  We  are  especially 
called  upon,  as  scientific  and  practically  useful  men,  to 
go  abroad  in  the  service  of  our  country ;  to  be  present 
with  all  expeditions  and  emigrations,  by  land  and  by 
water ;  always  as  conservators  of  the  lives  and  health 
of  others,  or  as  companions,  and  frequently  as  leaders, 
for  no  expedition  that  is  of  the  least  importance  to 
human  life  or  interests,  not  even  Christian  missions, 
can  move  without  us.  Thus,  everywhere,  in  every 
region  of  the  globe,  in  every  pursuit  of  life,  and  in  every 
stage  of  intellectual  culture,  we  must  be  present  to 
contribute  a  most  important  part  toward  "the  moral 
improvement  and  material  welfare  of  the  majority?" 

Such,  gentlemen,  is  the  position  we  occupy  ;  and  such 
is  the  nature  of  our  vocation,  the  usefulness  and  impor- 
tance of  which  cannot  be  exaggerated.  Have  we  quali- 
fied ourselves  to  fill  this  station,  to  discharge  these 
duties  ?  If  we  have  not,  whatever  estimate  we  may 
form  of  our  own  merits,  wc  must  not  expect  society  at 
large  to  view  them  in  the  same  light ;  and,  as  there  is  no 
appeal  to  Csesar,  its  judgment  will  be  final,  and  generally 


24 

sjjeakiiig,  just.  The  truth  is,  the  common  sense  of 
every  cultivated  people  is  rapidly  coming  up  to  the 
point,  at  which  even  the  most  profound  Doctor,  whether 
of  medicine,  law  or  divinit}^,  may  stand,  and  in  contem-, 
plating  the  range  of  his  intellect,  confess  that  all  men 
have  an  equal  right  to  the  hoon  of  knowledge  ;  where^ 
fore,  let  us  endeavor  to  secure  submission  to  our  pro-, 
fessional  advice  by  convincing  mankind  of  the  value 
and  safety  of  our  counsel,  rather  than  by  striving  to 
enforce  obedience  by  an  acknovvdedged  supremacy  of 
professional  authority.  By  our  fruits  must  vie  ask  and 
desire  to  be  judged.  If  they  are  like  the  apples  of 
Sodom,  we  deserve  no  better  than  a  Sodom's  fate.  But, 
if  they  are  pleasant  to  the  sight,  agreeable  to  taste,  and 
wholesome  to  body  and  mind,  we  have  a  right  to  expect 
of  our  fellow  citizens  ample  remuneration  for  our  services, 
and  that  they  will  cheer  us  on,  in  our  arduous  labors, 
with  their  approb.ation  and  their  smiles.  But,  gentlemen, 
if  we  hope  to  bring  forth  fruits  meet  for  the  rewards,  the 
approbation,  the  smiles  of  mankind,  there  is  a  consic  era- 
tion  of  paramount  importance,  which  I  have  not  touched 
upon  yet,  but  which  should  not  be  overlooked,  viz :  we 
must  ever  remember  that  no  professional  man  can  pre- 
serve the  public  favor  unless  he  possesses  the  respect  of 
his  own  profession ;  that  if  he  would  effectually  guard 
his  own  interest,  he  must  be  mindful  to  attend  to  the 
interest  of  others ;  and,  therefore,  that  he  must  be  stu- 
diously pareful  liberally  to  construe  that  part  of  medical 
ethics,  which  regulates  the  conduct  of  physicians  towards 
each  other,  and  towards  their  patients.  For,  after  all, 
medical  etiquette,  which  is  considered  by  some  persons 
as  a  sort  of  raw-head  and  bloody  bones,  is  nothing  more 
or  less  than  gentleman-lilve   deportment,  on  the  part  of 


li> 


mc(Uc<ri  men,  towarck  each  other  in  their  professional 
irelationship,  and  towards  the  patients  committed  to  their 
care.  It  may  all  be  learned  from  that  golden  rule, 
-'-  Bo  unto  others  as  you  v:ould  they  should  do  to  your 
On  this  hangs  all  the  professional  as  well  as  social  law. 
^*  As,  then/'  said  a  distinguished  member  of  our  profes- 
sion many  years  ago,  ^'we  value  our  own  characters,  we 
should  be  especiall}"  tender  of  that  of  others,  as  far  as 
that  can  be  consistently  with  truth,  and  with  a  due 
regard  to  the  w^elfare  of  those  committed  to  our  care." 
It  is  surely  wretched  architecture  to  attempt  to  build 
a  reputation  on  the  crumbling  remains  of  that  of  another. 
What  can  be  expected  of  such  a  structure,  but  that  it 
will  tumble  about  the  ears  of  the  builder,  and  perhaps, 
bury  liim  in  the  ruins.  Rest  assured,  that  however 
secretly,  or  cunningly,  any  one  may  manage,  ^Amhiguas 
sparcjere  voces ^  the  uncharitable  insinuation  will  be  dis- 
closed; for  such  things,  stone  walls  have  ears,  or,  to  use 
the  language  of  Solomon.:  "A  bird  of  the  air  shall  carry 
tlm  voice^  and  that  lokich  hatli  icings  shall  tell  the  matter^ 
Do  unto  others  as  you  ivould  they  should  do  to  you,  and 
when  your  "  way  of  life  hath  fallen  into  the  sear,  the 
yellow  leaf,'*  you  will  enjoy  golden  opinions  from  all 
..^orts  of  men, 

"  A.«  lioiior.  love,  obedienoo.  troops  of  friencls." 


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